MrHappyRotter:Meh, fortunately or unfortunately, I'm the type that avoids going to the doctor unless it's something pretty severe. I've always been that way, good or bad. I don't see any way I could afford anything more. Are people really paying for all these visits or is there insurance out there that's so good as to make doctor's visits affordable enough to make them a regular occurrence?

Basically this. Even with insurance, my last trip to the doctor still cost me ~ $140, and I got literally nothing out of it. I'm only going back if I feel like I'm dying.

Mistymtnhop:OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

If you've had symptoms for more than 10 days, you'll get antibiotics (might get an inhaler out of the deal too depending on what exactly's going on; those are always handy to have around for pick-up football games). You should probably go to the doctor and pick up a Z-pak.

RentalMetard:Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

If you've had symptoms for more than 10 days, you'll get antibiotics (might get an inhaler out of the deal too depending on what exactly's going on; those are always handy to have around for pick-up football games). You should probably go to the doctor and pick up a Z-pak.

/almost a doctor

Gee that's funny. When I was pregnant with my daughter, I reported that I had symptoms for over a month that prevented me from sleeping more than 2 hours a night due to severe coughing fits, that I was falling asleep standing up, and that the mucous was now coming out pink. The response was, "Try to get some rest during the day." A week later I was rushed to the hospital with a placental abruption, I delivered at 29 weeks and almost died from the blood loss.

I once had a doctor who looked like that tell me I had to lose weight.

In my late 20's I regularly saw a dermatologist for a condition I had at the time. He had all these posters up about "wear your sunscreen" and "stay in the shade" and "is this mark on my skin bad?" He was always warning about how one can get skin cancer, the horrors of it, all that. And then after one visit I walk outside and there he is, under a tree, smoking a farking cigarette.

Mistymtnhop:OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

Thats the worst -- i hate it when supervisors insist on a doctors note if you call in sick.

If im sick with the flu or a cold then spending 5 hours in an uncomfortable room so a doctor can tell me to get some rest and drink lots of fluids seems pretty dumb. Then the supervisors will say - if you arent sick enough to go to the doctor then your not sick enough to miss work. And thats retarded because you are drooling snot left and right and your fever is making you feel like every room is ice cold and you are slopping germs on everything you touch and being completely unproductive.

I recommend yearly cancer screening starting sometime in the thirties. You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them. Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps. If you are a woman, check your breasts.//No really, do it right now. Fark's readership is big enough that statistically, one of you has a good chance of having cancer.

Gyrfalcon:NuttierThanEver: Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick" with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven

Plus, the purpose of those "pointless" annual blood tests, urinalysis, etc., is to provide a baseline against which to compare subsequent tests. A better way to warn people against them is to say if the annual test comes back "abnormal" to say "let's not go to the biopsy just yet. Let's do another test in six months and see how that one comes out." There could be a myriad of reasons why your blood work is "abnormal" on any given day. But you do need to have a series of numbers so that the doctor can look at it and say "see, these numbers have been MOSTLY the same for the last 15 years and now suddenly they're not; something could be wrong;" as opposed to two or three random numbers that are all different.

This. I got a "pointless" ECG a month ago. I have no heart issues, I'm perfectly healthy (despite a most likely unrelated problem) but I also haven't had one since I was in the hospital with sepsis 11 years ago in high school. The thing was all kinds of messed up and I had to do a series of tests that showed all the abnormalities were just normal variants (the damn thing said I was having a heart attack. I was not having a heart attack). It will however, serve as a baseline so I don't have to do all those other tests all over again next time a doctor notices the same thing. It's the same reason people do levels of markers that are not at all specific (like PSA or CA-125). They don't mean much alone (again, not specific) but if you get a huge jump you pay attention. They also can monitor the course of the disease. I guess it's one thing to run to the doc for every minor thing, but annual check-ups are a little different.

Great Justice:I recommend yearly cancer screening starting sometime in the thirties. You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them. Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps. If you are a woman, check your breasts.//No really, do it right now. Fark's readership is big enough that statistically, one of you has a good chance of having cancer.

Eh...

TFA: A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive.

Unless there's something in your personal or family history that suggests a substantially higher risk of cancer, I can't imagine any earthly reason a thirty-something should be doing annual checks for cancer.

juvandy:The article isn't about how bad it is for you to visit a doctor on semi-regular visits for checkups...The article is about how much it is costing the overall health-care system in raw dollahs. The author's cost/benny analysis, the over-doctoring is not worth the "relatively minimal" (quotes are mine) lives saved by these visits, vs. the dollahs spent.

Well, it does also touch on the effects of false-positive test results on patients' health (via post-test exploration) and mental anxiety. False positives are a real problem given that doctors don't know the underlying statistics well enough to comprehend what they mean, let alone to explain it to their patients. The article itself even gets it wrong when it implies that a false positive rate will necessarily increase your risk of getting a false positive the more times you see a doctor. Technically, the probability doesn't change. What it does mean is that a test with a 10% false positive rate doesn't indicate that a positive = a 90% chance of a true positive.

Actually, we are taught the important concepts of statistics (false pos, false neg, specificity, sensativity, pos predict value, neg predictive value, and so on) from the start of medical school. Along with being taught the actual stats for various diseases, and weighing the benefits to risks for just about everything down to an algorithm. On top of how to break this down to patients. These things are pretty heavily tested on our licensing exams.

orclover:cameroncrazy1984: cchris_39: Slate is predictably doing its part to lay the groundwork for restricting care.

Care already IS restricted, you derpaholic.

For the most part its not restricted. You might end up paying it off for the rest of your life. Or fall into financial ruin. Or just say farkit and kiss that useless credit goodbye. But yea you can get care. Then you are farked, financialy.

People just need to buy more money though, all this debate is just stupid. Hell ask their parents for a raise if they have to.

Not legally restricted, but yes it is restricted. You take 4 days to treat pneumonia when the next guy took 3 (regardless of the patient profile and individual situation)? You get a call from Humana saying they're dropping as an approved physician. It's not just patients that have to watch their asses. Or if you try to order a test without justification? You will be getting a call. And, Medicare will show up to your office and examine 5 years of records and find every way to not reimburse you. The fact that we're taught how to avoid these things just as much as we're taught actual medicine is telling.

Well, great. I didn't feel like getting that pelvic exam anyway, then when I'm dying of lady bits cancer, I can at least look at this Slate article and know I did everything I should have done to prevent it!

The whole going to the doctor because you have a cold thing has to stop. Not every little sniffle needs an antibiotic. This world is full of hypochondriacs. I know 2 females in their 20's who swear they have debilitating diseases and NEED to go to the doctor (specialists, no less) multiple times per year. One of them went to 3-4 different doctors, and was finally happy when one of them gave her a pill to take to ease whatever disease it is she thinks she has at the moment. (Of course, she only stays on these pills long enough for the sympathy to wear off.) Then there were the sleep studies that showed she was normal, and she didn't believe. Cripes.

If I have to sit through one more conversation about this gal's rotten vagina, sleep issues, PMDD, or alleged lactose intolerance (while drinking milk and eating cheese), I'm going to scream.

RentalMetard:Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

If you've had symptoms for more than 10 days, you'll get antibiotics (might get an inhaler out of the deal too depending on what exactly's going on; those are always handy to have around for pick-up football games). You should probably go to the doctor and pick up a Z-pak.

Bumblefark:Great Justice: I recommend yearly cancer screening starting sometime in the thirties. You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them. Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps. If you are a woman, check your breasts.//No really, do it right now. Fark's readership is big enough that statistically, one of you has a good chance of having cancer.

Eh...

TFA: A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive.

Unless there's something in your personal or family history that suggests a substantially higher risk of cancer, I can't imagine any earthly reason a thirty-something should be doing annual checks for cancer.

The advice on self-checks, though -- yeah, no argument there.

The problem with cancer is that there are just so many things that can cause it. Sunlight exposure, diet, breathing smoke (recreational or industrial), radon, chemicals in your water table, and yes, the dreaded family history which means you will give yourself cancer!

That scary study does indeed indicate a high rate of false positives, but in the case of cancer a false positive is generally better than a missed actual. For most of your health, you can just stay healthy, but you have so little control over your carcinogenic exposure; its all who you are and where you live.

Its one test a year, and it can save you so much pain, and give a little bit of peace of mind too. Better safe than sorry.

/and in case you didn't catch it, "looking for cancer in the likely places" means a doctor sticks his finger up..well...you know...

Half of the world's doctors graduated at the bottom 50% of their class.

It's that simple.

Google can really be smarter than your GP. Or not.

Good luck, citizen.

Bad doctors are far more dangerous to more people than any "bad cop thread," Let us rate doctors on Yelp or TripAdvisor and we would see real advances, "Modern Medicine" is a load of horse puckey. Even rate them among auto-parts stores for comparable service, and they would lose. Badly. Doctors suck. Really. "Oh, I graduated at the 37th percentile in my class!" Personally, I would call that a fail.

I once had a doctor who looked like that tell me I had to lose weight.

In my late 20's I regularly saw a dermatologist for a condition I had at the time. He had all these posters up about "wear your sunscreen" and "stay in the shade" and "is this mark on my skin bad?" He was always warning about how one can get skin cancer, the horrors of it, all that. And then after one visit I walk outside and there he is, under a tree, smoking a farking cigarette.

It's moments like that you realise you need to change doctors.

I'm sure he's aware smoking is bad for you and wouldn't recommend it based on his own personal poor decisions. Mine was pretty obese but this really didn't influence his advice to wear sunscreen, recommendations for what kind to pick up at the store, how to still get enough sun for Vitamin D, and to check for moles.

MylesHeartVodak:Half of the world's doctors graduated at the bottom 50% of their class

Yogi Berra, is that you? Sounds like you've spent some time researching and thinking about this, I'll certainly take your word for it.

That's just ridiculous logic. You seem to be forgetting how competitive medicine is, and the fact that there's waaaay less spots compared to applicants, both in the first 4 years and in residency. Plenty of people that are waitlisted or plain don't get in are perfectly capable of becoming great doctors - there's just not enough spots. There's also these things called basic sciences, comp, licensing (those things that residency programs actually care about) and board exams that not only have to be passed, but have to be passed with flying colors to secure a residency and/or have a chance of succeeding as a doctor. Also, most US med schools are pass/fail and they hold you hand to make sure you pass to keep that attrition rate down. So yeah...

Five Tails of Fury:Hey, not cool, man. Those visits help pay for hard working doctors' second and third boats, you know!

Sounds like you know a lot of doctors (sarcasm). Really hard to do when you have 250K of debt not counting the cost of buying into a practice. And the whole 12 total years of schooling past high school. And the fact that you have absolutely no time and no life to enjoy those alleged 3 boats.

Mistymtnhop:OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

Maybe so he can tell you to STAY THE FARK HOME and stop getting everyone else sick!

/tired of these "such a trooper" students and employees//you're not a trooper, you're a jackass prolonging your own illness and passing it to everyone around you

Spiralmonkey:Apart from anything else a healthy person in a doctor's waiting room will pick up every variety of sniffles, coughs, inexplicable rashes and galloping knob rot that could possibly exist on Satan's Petri dish.

My adopted Mom, who worked as an ER Nurse for over 22 years said it best:

Great Justice:Bumblefark: Great Justice: I recommend yearly cancer screening starting sometime in the thirties. You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them. Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps. If you are a woman, check your breasts.//No really, do it right now. Fark's readership is big enough that statistically, one of you has a good chance of having cancer.

Eh...

TFA: A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive.

Unless there's something in your personal or family history that suggests a substantially higher risk of cancer, I can't imagine any earthly reason a thirty-something should be doing annual checks for cancer.

The advice on self-checks, though -- yeah, no argument there.

The problem with cancer is that there are just so many things that can cause it. Sunlight exposure, diet, breathing smoke (recreational or industrial), radon, chemicals in your water table, and yes, the dreaded family history which means you will give yourself cancer!

That scary study does indeed indicate a high rate of false positives, but in the case of cancer a false positive is generally better than a missed actual. For most of your health, you can just stay healthy, but you have so little control over your carcinogenic exposure; its all who you are and where you live.

Its one test a year, and it can save you so much pain, and give a little bit of peace of mind too. Better safe than sorry.

/and in case you didn't catch it, "looking for cancer in the likely places" means a doctor sticks his finger up..well...you know...

Yeah...I still dunno. I don't think you can just wave away false positives as a "better safe than sorry" thing. Those sorts of errors have very real implications for the patient -- not only in terms of financial and psychological costs, but also the risk of unnecessary and potentially harmful medical interventions while the false diagnosis is in effect.

Annual screenings beginning in your 30s makes it highly likely (depending on what you're being screened for) that you're going to get a false positive at some point within the next 20 - 30 years -- and to guard against what? The 0.1% chance that you're a 30-something with cancer?

I mean, to each their own, but that seems like a pretty crappy tradeoff.

/And, I don't think I'm being cavalier about the possibility of being that 0.1%, either. I'm a 30-something who got some (non-routine) tests this last week.//Looks like I should be in the clear, at least presently, but -- yeah, unsettling stuff.

EmmaLou:One of them went to 3-4 different doctors, and was finally happy when one of them gave her a pill to take to ease whatever disease it is she thinks she has at the moment.

While there certainly are hypochondriacs there are also the difficult-to-diagnose things that often end up with patients seeing a series of docs. I was on doc #6 when I got a partial answer that sure made my life better and it was a lets-try-this-just-in-case thing. I don't fit their pigeonholes, they decide what I describe simply can't be right and I got a psych referral out of that--and it took the shrink almost no time at all to figure out I wasn't nuts. Being good at identifying triggers doesn't mean it's psychosomatic, it simply means I know how to figure them out.

MylesHeartVodak:Bad doctors are far more dangerous to more people than any "bad cop thread," Let us rate doctors on Yelp or TripAdvisor and we would see real advances, "Modern Medicine" is a load of horse puckey. Even rate them among auto-parts stores for comparable service, and they would lose. Badly. Doctors suck. Really. "Oh, I graduated at the 37th percentile in my class!" Personally, I would call that a fail.

There's a big problem here. The doc who does what his patients want would rate highly. You don't really want the doc who hands out antibiotics for colds getting a high rating. A patient can rate how they were treated, they can't really rate the medical advice too well.

Mistymtnhop:OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

Two weeks is long for a cold. You could have developed a sinus infection. These are often bacterial and can be treated with antibiotics. Even if it's viral, you can get some relief from your symptoms. You really should see a doctor.

Bumblefark:Annual screenings beginning in your 30s makes it highly likely (depending on what you're being screened for) that you're going to get a false positive at some point within the next 20 - 30 years -- and to guard against what? The 0.1% chance that you're a 30-something with cancer?

I mean, to each their own, but that seems like a pretty crappy tradeoff.

Agreed. My doctor once convinced me to get an ultrasound to check out a cyst she found. Its conclusion, "Might be lady-parts cancer, check it again in 6 months." The followup ultrasound was clear, but they found a kidney stone. My doctor wanted to send me to a specialist just in case for that too. My response was, "Will it kill me before I get symptoms? No? Then NO."

Oh, and my thyroid tests keep coming back "sub-clinical", "just barely within range" and "borderline, better keep an eye on it" even though I DO have symptoms, and a family history, and there's a simple pill to treat the problem! But no, better to poke around for things we might get to biopsy instead.

There have been people who have ended up dead because they thought they just had a virus or something else that they'd be over soon and didn't go to the doctor. So how does one tell when they really do need to go to the doctor and when doing so wouldn't help anything?

Too frequently, I have a little kid (5-10 years old) being brought in by their mother, and there is basically nothing wrong with them. I explain that patiently to the mom ("Looks like it's just a bruise. He's moving his arm without pain and there's no limitation, and it was a small injury anyway. We certainly don't need to cast it or operate on it or anything else. It'll just get better if we let it be.")

And, no lie, the mom will say, "Oh, I know. He just wanted to come to the doctor to make sure it's OK."

I've gotten to the point where I look at the mother and politely but clearly ask who the grownup is in the family. Sometimes I give a couple of sentences about how, if you're participating in letting them think the world is a scary and dangerous place, then they're going to carry that with them forever - and it's not a good thing.

Let's say I'm a doc with a private practice. How do I know that I can pay my mortgage and car payment? I must have some form of ongoing, baseline income.So I tell people to come in, once a year, just to make sure things are OK. Boom! Instant cash flow.

Over the years, we've found that - in big population studies - only certain tests are useful. These screening tests (e.g., mammography) are mandatory. Some even more so, if you probably have a genetic time bomb (e.g., breast cancer in your mom).But most stuff is a waste of time and money. And health care costs skyrocket because of all the unnecessary crap we do to people.

Some of that unnecessary crap is due to patients' anxiety and, frankly, ignorance. Plenty of misinformed folks out there.And a large part of it is due to lawyers, and their need to make a buck by suing for "malpractice." Their need to generate income regularly leads to the same unnecessary litigation that the yearly physical leads to.

Oh, so the insurance companies are tired of paying for well visits? And they can kill two patients with one stone since people who don't do well visits won't find the fatal conditions that would kill them early until it's too late. Every diabetic we kill before we have to start paying for their treatment saves us money!

Fark insurance companies as hard as possible, man. Bend them over and fark them in the sewer pipe with a rubber full of broken glass.

Somehow it never makes me feel better when an MD asks me what kind of scientist I am (because they see that under "occupation") and I tell them and they inevitably groan and say how hard they found that subject.